Abstract
Aims and Objectives: To find out the efficacy of negative pressure on healing of complex acute and chronic wounds and contaminated laparotomy wounds.
Methods: This prospective randomized experimental study was conducted on a total of 64 consecutive patients with different types of surgical wounds. They were randomly divided into two equal groups. There were 32 patients in each group. The study group or group A received negative pressure wound therapy, whereas group B or control group received conventional normal saline gauze dressings. The mean duration of treatment was 4 weeks (range 2 to 6 weeks). The different parameters of wound healing were analyzed using Chi-square test and Z test.
Results: Patients with NPWT had faster disappearance of wound exudates, earlier appearance of granulation tissue and faster wound healing. No significant difference in bacterial clearance was found. Pain during dressing changes due to in growth of granulation tissue was the most common complication found in NPWT.
Conclusions: NPWT is associated with faster wound healing with fewer acceptable complications. It is particularly effective in dealing with complex or difficult surgical wounds.
Keywords: wound exudates, sub atmospheric pressure, surface area of wound, granulation tissue, bacterial bio burden, negative pressure, wound closure.
References
- Argenta I.C, Morykwas MJ: Vacuum assisted closure: A new method for wound control and treatment: Clinical experience. Ann plast surg 38:563-576; discussion 577, 1997.
- Joseph E, Hamori CA, Bergman S et al: A prospective randomized trial of vacuum-assisted closure versus standard therapy of chronic non healing wounds 12:60-67,2000.
- Timmers MS, L.C Cessie S, Banwell P, et al: The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg 55:665-671, 2005.
- Chen SZ, Li J, Li XY, et al: Effects of vacuum-assisted closure on wound microcirculation: An experimental study. Asian J Surg 28:211-217, 2005.
- Sibbald RG, Maleoney J,V.A.C. therapy Canadian consensus group. A consensus report on the use of vacuum-assisted closure in chronic, difficult to- heal wounds. Ostomy wound manage 2003;49(11) 52-66.
- Sinha K., Chauhan V.D., Mahashwari R., Chauhan N., Ranjan M., Agrawal A. Vacuum assisted closure therapy versus standard wound therapy for open musculoskeletal injuries. Adv orthop. 2013[PMC free article][Pub Med].
- Morykwas M.J., Argenta L.C.,Shelton-Brown E.I, McGuirt W: Vacuum-assisted closure: a new method for wound control animal studies and basic foundation. Ann Plast Surg, 38(1997),pp 553-562.
- Tan A. Smith S.F. et al: Should infected laparotomy wounds be treated with negative pressure wound therapy?: Science Direct: International journal of surgery. Volume 12,Issue1, January 2014, Page26-29.
- Li P.Y., Yang D.,Liu D.et al: Reducing surgical site infection with negative pressure wound therapy after open abdominal surgery: A prospective randomized controlled study. Scandinavian journal of surgery, Sept-8,2016.
- Grauhan O, Hetzer R. et al: Prevention of post sternotomy wound infection in obese patients by negative pressure wound therapy. The Journal of thoracic and cardiovascular surgery. Vol-145, Issue 5, May 2013, Pages-1387 to 1392.
- Weed, Tonja; Raflift, Catherine RN; Drake, David B: Quantifying bacterial bioburden during negative pressure wound therapy: Does the wound V.A.C enhance bacterial clearance? Ann. Plastic Surg. March 2004-vol 52. Issue 3-p 276-279.
- Moue..s CM, et al: Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen.2004 Jan-Feb.[Pub Med]
- Mendez-Eastman S1.: Negative pressure wound therapy. Plast. Surg. Nurs.1998 , spring; 18(1):27-9, 33-7.
- Schwien T, Gilbert J, Lang C. Pressure ulcer prevalence and the role of Negative Pressure Wound Therapy in home health quality outcomes. Ostomy Wound Manage.2005; 47-60.[Pub Med].
- Moisidis E, Health T, Booren C, Ho K, Deva AK. Aprospective, blinded, randomized controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg.2004; 114:917-22.[Pub Med].
- Etoz A’, Kahveci R et al: Negative Pressure Wound Therapy on diabetic foot ulcer.Wounds.2007 Sept; 19(9):250-4.
- Kantak NA, Mistry R, Varon DE, Halvorson EG: Negative pressure wound therapy for burns. Clin. Plast. Surg. 2017 Jul;44(3): 671-677.
- KCL clinical guidelines, p-4.
- P. Stannard, J.T. Robinson, E.R. Anderson, G. McGwin Jr ,D.A. Volgas, J.E. Alonso: Negative pressure wound therapy to treat hematomas and surgical incisions following high energy trauma. J Trauma,60 (2006),pp.1301-1306.
- Etoz A, Ozgenei Y, Ozcan M: The use of negative pressure wound therapy on diabetic foot ulcer: a preliminary controlled trial. Wounds, 16(2004), vol 16, issue 8, pp 264-269.
- Daniel de Alcantara Jones, Wilson Vasconcelos Neves Filho, Janice de Souza Guimaraes, Daniel de Araujo Castro, Antonio Marcos Ferracini:The use of negative pressure wound therapy in the treatment of infected wounds. Casestudies. Rev Bras Ortop.2016 Nov-Dec;51(6):646-651.
- Upton D, Stephens D, Andrews A: Patient’s experiences of negative pressure wound therapy for the treatment of wounds: a review. J Wound Care.2013 Jan;22(1):34-9.
Corresponding Author
Swarup Chakraborty
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.65
